Last Abortion Clinic in Canadian Province to Close

When Kandace Hagen told the nurse at her family doctor’s office she wanted to terminate her pregnancy, the woman abruptly stopped speaking to her. But she scribbled the name of the Morgentaler Clinic in Fredericton, New Brunswick, on a piece of paper before quickly leaving the room. “The entire atmosphere was very cold, very unsupportive,” Hagen, a Prince Edward Island native, recalls. “I assumed that was how women who wanted abortions were treated.”

Hagen had learned she was pregnant in July 2009 and knew immediately she couldn’t go through with it. A university student and already a mother to a young son, she felt it wasn’t the right time to have another child. But there are no abortion clinics on Prince Edward Island, the smallest of Canada’s 13 provinces and territories (population just over 145,000). And she didn’t know that her doctor could have referred her to a hospital in the province of Nova Scotia, where she could have had the procedure done for free. Instead, she made the four-hour trip to Fredericton and paid $1,000, because Morgentaler was a clinic of last resort.

But now, five years later, the Morgentaler clinic, which helped so many women like Hagen, will close its doors for good. After a 20-year funding battle with the government of New Brunswick, the clinic announced it will no longer offer its services after July 18. “It breaks my heart to have to do this. It absolutely does,” clinic manager Simone Leibovitch told reporters. “And I’m not sure what women are going to do after we leave. I really have no idea.”

The clinic has provided abortion services to more than 10,000 women since it opened in 1994, with roughly 10 percent of its clientele coming from Prince Edward Island. The unspoken policy of the clinic has been to never turn away a woman in need, and, consequently, the doctors have performed countless pro-bono abortions. Between providing free services and lacking sufficient provincial government funding, Morgentaler’s closure seemed almost inevitable. But the loss has laid bare the hurdles women in New Brunswick and Prince Edward Island face when trying to access safe, legal abortions, even with Canadian constitutional and health laws on their side.

In the 1988 R. v. Morgentaler decision—essentially Canada’s Roe v. Wade—Canada’s Supreme Court ruled that the country’s then-criminal abortion provision was unconstitutional, as it violated a woman’s right to security of the person established in the Charter of Rights and Freedoms. Under the Canada Health Act of 1984, the procedure is described as medically necessary, which means it should be covered by provincial health care, regardless of whether it is performed in a clinic or hospital.

Neither New Brunswick nor Prince Edward Island’s governments responded kindly to the 1988 ruling. The next year, New Brunswick tacked on regulation 84-20 to its Medical Services Payment Act, requiring women get written approval from two doctors that their abortion would be “medically necessary,” and stipulating that the procedure could only be performed by a gynecologist in one of two authorized New Brunswick hospitals. And Prince Edward Island remains the only Canadian province that doesn’t offer abortions within its territory.

The deal that Prince Edward Island made almost two decades ago—to only fund abortions for women whose physicians referred them to a Nova Scotia hospital—was quietly arranged but not advertised until 2011. Women like Hagen, whose physicians didn’t volunteer the information, suffered the consequences. Even with the Nova Scotia option available, over half of Prince Edward Island women who leave the province for an abortion don’t have a referral, and the Morgentalerclinic remained their only hope. Says Colleen MacQuarrie, a professor at the University of Prince Edward Island,

For the last 28 years, women in P.E.I. have been medical refugees in search of reproductive justice and safe abortion options. What an important beacon of choice for reproductive justice that clinic served. My heart aches thinking about the consequences.

She’s not wrong to be concerned. In New Brunswick, where 60 percent of women seeking abortion services don’t meet the province’s funding requirements, women will lose the single unrestricted avenue to the procedure. And Island women, MacQuarrie thinks, will lose hope.

In January, the professor published a research paper on the “trials and trails” women on the island faced when they tried to access abortion. She was alarmed to find that many had tried to self-induce, and spoke about suicidal ideation:

I’m just very deeply worried that we’re going to see more women do things in acts of desperation. I can’t imagine what life will be like here when the clinic closes if the province doesn’t have a better option.

Better options have not been forthcoming. Following the clinic’s announcement, New Brunswick pro-choice activists rallied in front of the legislature, calling on the government to revoke regulation 84-20. Conservative premier David Alward has asserted that the regulation doesn’t need changing, and the opposition Liberal party will only commit to “studying” the regulation if they form a government. But activists such as former clinic escort Kathleen Pye are optimistic that they can start making changes come September elections. “I think now there’s no doubt that it will be … an election issue, whether they want it to be or not.”

Island legislators have used the excuse for years that people have to leave the province for other medical procedures, and that abortion’s no different. But when the National Abortion Federation put forward a proposal for a twice-monthly clinic on the island, with the support of a Nova Scotia doctor who offered to come to the island to perform the procedures, it was initially approved and then abruptly shut down.

MacQuarrie says that, unlike in New Brunswick, the Morgentaler clinic’s closure is unlikely to prompt change on Prince Edward Island because of its staunch anti-choice climate. She says,

The specter of violence is there, holding people in an anti-choice pattern. So even though we have lots of people who may be choice supporters, there’s a strong element of fear about what happens when you speak out.

Both provinces are in violation of the Canada Health Act, and can be penalized by the federal government in the form of having health transfer payments withheld. But both Prime Minister Stephen Harper and health minister Rona Ambrose have refused to get involved, calling it a provincial issue. Says Niki Ashton, a member of parliament from the New Democratic Party,

Clearly a major obstacle here is a federal government that’s unwilling to move. The government of Canada should step up and take a leadership role in ensuring equitable standards across the country for women’s reproductive health.

When Hagen learned the clinic that had helped her when she was in need would close, her first emotion was frustration. “To find out that the key resource that was available to Island women is no longer available is definitely a blow to reproductive justice in the Maritimes,” she says. “It feels like we take one step forward and then we take 10 steps back.”

Meanwhile, there’s still a shred of hope that the Morgentaler Clinic could remain open. The group Reproductive Justice New Brunswick has started a crowd-funding initiative with the goal of reaching $100,000, and more than $83,000 has already been pledged. In a news conference last Friday, Kathleen Pye called it a “bandaid solution” for the access issues faced by women in New Brunswick face—specifically regulation 84-20. If the group does not meet its goal by July 31, the money raised will go toward efforts to overturn the Medical Services Payment Act.

Does Baffin Regional Hospital no longer provide abortion in Nunavut? They used to be the go-to for abortions in Nunavut. It is worth noting though that Nunavut pays the travel expenses for a person to go to the nearest abortion clinic, even if it’s in a different territory or province, and covers the complete cost of the abortion, which still makes it much more accessible than PEI.

In university I obtained an abortion from the Morgentaler clinic in Toronto. Yes, it was clinical, but it is a medical procedure after all. The staff, while being “clinical” were nonjudgemental. Never once did I feel anyone in the clinic, from the check in to discharge, was judging me. It was what it was. To me I was treated no differently there than I was at my local lab where I get blood work done, which I thought was amazing. In normalising abortion as “just another medical procedure” the staff took away a lot of my guilt. You don’t feel guilty going to the hospital with a broken arm, or to the walk in clinic with a case of strep.

That said, Ontario’s health care system is different than PEI – I didn’t even require a doctor’s note. I called, terrified and 18 years old, explained I was pregnant and was asked a few medically necessary details (allergies, how far along, date of last period), was given an appointment and TTC instructions. I didn’t see a doctor until after I had the procedure for follow up.

I work with single parents every day and the province of New Brunswick and the anti-choice side does nothing on the other end either to ensure that all those forced into motherhood have adequate supports so most of these children are raised in environments stricken by poverty. Child support enforcement is also appallingly bad. We have laws and regulations that apparently can be ignored. I am anxiously awaiting the next provincial and federal elections.

The Morgentaler Clinic was named for Dr. Henry Morgentaler, a great humanitarian who went to prison because of his support for women’s full range of reproductive choices. It is indeed tragic that his legacy is being partially obliterated by the closing of this clinic. He knew, fifty years ago, that women’s well-being depended on access to safe and affordable medical care and the ability to make their own reproductive health care decisions. This is a sad day.

The map has numerous errors though. The Nunavut hospital provides abortions. There are no clinics in Nova Scotia. Quebec pays fully for abortions at clinics. Some abortions in Ontario are not fully funded, primarily those done in private doctor’s offices as well as clinics that opened after about 1997. Also, it’s not quite correct to say that “In New Brunswick, where 60 percent of women seeking abortion services don’t meet the province’s funding requirements,” The problem is the difficulty of finding two doctors to give approval, and then the long wait. So most women turn to the clinic instead.

Before 1988, availability of “therapeutic abortions” varied considerably around the country. Let’s face it, abortions are medically necessary, since any elective abortion is medically safer to a woman’s health than continuing to the risky consequence of late pregnancy and delivery; but for example, in British Columbia, a woman with an unwanted pregnancy had to have her medical records reviewed by the Therapeutic Abortion Committee at the local hospital (good luck, hope it’s not Catholic–hospitals did not have to have one–don’t think they all had to be MD’s either), and that was the only place to have a legal termination of pregnancy, but there was no cost to the patient. In Vancouver, things were OK for years, but elsewhere, you might have to travel a long way. Dr. Morgentaler was a real hero to a lot of us, and we found out after his death that his own personal funds paid for many, many procedures at the clinics.

He and many other heroes have been attacked by anti-choice terrorists here in Canada, to try to take away women’s right to control their own bodies, but we still have abortion as a decision between a woman and her health care provider. Obviously, there’s still a big fight in the Maritimes to make sure women can afford reproductive health care, though.

I would like to see/hear more discussion in the mainstream about men who impregnate women and what they intend to do to support all the babies they are helping to create. Those who oppose sex education, birth control access and abortion never mention male responsibility.